Although quilting is not unique to the United States, it is a traditional art form that was well developed by American pioneers of the 19th century. Early quilts were primarily utilitarian, and most often used as a blanket for protection against the elements. They typically comprised two fabric sheets with some form of batting between them. The batting provided insulation while the outer sheets protected it. Since the batting was often scavenged from scraps of other fabric or various wads of cotton, wool, or other fibrous materials, stitches were sewn through the layers at intervals to stabilize the batting so that it remained relatively evenly distributed and did not migrate into lumps.
As the art form developed, the top sheet, which had been a single piece of fabric, was replaced by mosaics that were created by stitching together many small pieces of fabric. Some of these mosaics were created full-size to replace the top sheet in its entirety, while other smaller mosaics may have been appliquéd to the top sheet for decoration. The backside of the quilt generally remained as a solid, unadorned sheet.
Another development was the use of quilting stitches. Although initially these were merely intended to avoid migration of the batting, they became another means of artistic expression. Stitches were placed in patterns to describe the outlines of flowers, animals and other items seen in nature. Other common stitch patterns included stars, hearts and a variety of symbols. Some of the quilt stitches were used to trace the pieced pattern from the top sheet, while other stitches were simply decorative. While the men from among the American pioneers gathered as neighbors for barn raisings, the pioneer women gathered to meticulously apply their stitches to large quilts.
As quilts have become less utilitarian, they have advanced artistically to the extent that they are used as wall hangings as often as for bed coverings. Though many quilters and quilt aficionados still give high regard to the detailed regularity and patterns of stitches, the average attendee at present-day quilt shows is more likely to be drawn visually to a quilt on account of its pieced top, whether for its colorful pattern or the intricacy or detail of the piecing. Occasionally, quilts are created that have both of the front and back faces pieced to create a double-sided quilt. This is generally done in order to provide a single quilt that is usable for two different themes, such as for spring and summer, or for Thanksgiving and Christmas.
The easiest way to produce a quilt wherein both faces are pieced is simply to create each face by piecing it independently of the other. Appropriate borders are then added so that the sizes of the two faces match, then the two faces are sandwiched with the batting and the composite is stitched together. In many cases this is acceptable. Difficulty with this approach arises when it is desired to use quilting stitches to accent the pieced work of one face or the other, since it is likely that stitches used to trace the pieces of one face will appear out of character against the opposite face. Even if the two faces were pieced in identical patterns, with one being the mirror image of the other, it would be difficult to properly register them so that stitches quilted on one face would properly align with the opposite face.